Defining substance abuse

1
Defining substance abuse

• Health Psychology

2

• Introduction to Substances

3
Definitions of Substance Use/Abuse/Dependence
4
Abuse

• A maladaptive pattern of substance use, leading
  to a clinically significant impairment or
  distress, as manifested by one (or more) symptoms
  occurring at any time in the previous 12 months

5
Abuse Symptom 1

• Recurrent substance use resulting in a failure to
  fulfill major role obligations at work, school,
  or home.

6
Abuse Symptom 2

• Recurrent substance use in situations in which it
  is physically hazardous.

7
Abuse Symptom 3

• Recurrent substance use-related legal problems.

8
Abuse Symptom 4

• Continued substance use despite having persistent
  or recurrent social or interpersonal problems
  caused or exacerbated by the effects of the
  substance.

9
Dependence

• A maladaptive pattern of substance use, leading
  to a clinically significant impairment or
  distress, as manifested by three (or more)
  symptoms occurring at any time in the previous 12
  months

10
Dependence Symptom 1

• Tolerance as defined by either
• A need for markedly increased amounts of the
  substance to achieve intoxication or the desired
  effect
• Markedly diminished effect with continued use of
  the same amount of the substance

11
Dependence Symptom 2

• Withdrawal as manifested by either
• The characteristic withdrawal syndrome for the
  substance
• The same or closely related substance is taken to
  relieve withdrawal symptoms

12
Dependence Symptom 3

• The substance is often taken in larger amounts
  than intended

13
Dependence Symptom 4

• There is a persistent desire or unsuccessful
  effort to cut down or control substance use

14
Dependence Symptom 5

• A great deal of time is spent in activities
  necessary to
• Obtain the substance,
• Use the substance, OR
• Recover from its effects

15
Dependence Symptom 6

• Important social, occupational, or recreational
  activities are given up or reduced because of
  substance use

16
Dependence Symptom 7

• The substance use is continued despite knowledge
  of having a persistent or recurrent physical or
  psychological problem that is likely to have been
  caused by the substance

17
Developmental Considerations

• Basic Theory and Support
• A number of researchers have suggested that
  occasional drug use may be best understood as a
  manifestation of developmentally appropriate
  experimentation.
• In a longitudinal study by Shelder and Block
  (1990), at age 18, relative to Experimenters,
  both Heavy Users and Abstainers appeared to be
  less psychologically healthy.
• Evidence of suboptimal personality development
  and parenting were found at ages 7 and 11, thus
  predating any drug use.

18
Gateway Theory of Drug Use

• Basic Features
• Sequencing implies that there is a fixed
  relationship between 2 substances, such that one
  substance is regularly initiated before the
  other.
• Association implies that initiation of one
  substance increases the likelihood of initiation
  of the second substance.
• Causation implies that use of the first substance
  actually causes use of the second substance
  (Causation is not supported by the gateway
  theory).
• Strongest argument that can possible be made
  Use of a drug at a lower stage may be a
  necessary but not a sufficient condition for
  progressing to a higher stage (Kandel, a gateway
  theory researcher).

19
Properties of drugs
Physical Dependence Psychological Dependence Tolerance
Cocaine Limited Yes No
Amphetamines Limited Yes Yes
Alcohol Yes Yes Yes
Marijuana Mixed support Yes Little
Narcotics (opium, morphine, heroin) Yes Yes Yes
Synthetic/designer (LSD, MDMA) No Yes Yes
Hallucinogens (Mescaline, No Yes Yes
Nicotine Yes Yes No
20
Theories

• Theories that have been developed to explain
  addictions and addictive behaviours, include
• Moral Models, which regard an addiction as a
  result of weakness and lack of moral fibre
• Bio Medical Models, which see an addiction as a
  disease and
• Social learning theories, which regard addicted
  behaviours as behaviours, which are learned
  according to the rules of learning theory.

21
Withdrawal

• Withdrawal refers to unpleasant physical and
  psychological symptoms people experience when
  they discontinue using a substance on which the
  body has become physically dependent. The
  symptoms experienced depend on the particular
  substance used, and can include anxiety,
  irritability, intense cravings for the substance,
  hallucinations, nausea, headache and tremors.

22
Substance abuse

• (according to Rosenhan and Seligman, 1984)
• Existence of a clear pattern of pathological use,
  such as heavy daily use and an inability to stop
  or decrease using it.
• Heightened problems in social or occupational
  functioning resulting from substance use, as when
  a person loses friends or jobs repeatedly because
  of it.
• The existence of pathological use for at least a
  month.

23
The end